Broadhead RS, van Hulst YC, Houser RL, Altice FL; National HIV Prevention Conference (2003 : Atlanta, Ga.).
Abstr Book 2003 Natl HIV Prev Conf July 27 30 2003 Hyatt Regency Atlanta Hotel Atlanta Ga Natl HIV Prev Conf 2003 Atlanta Ga. 2003; abstract no. M2-F0801.
University of Connecticut, Storrs, CT
BACKGROUND/OBJECTIVES: (This panel consists of three presentations, and 30 minutes will be devoted to panel members' interaction and discussion with the audience.) HIV+ Drug Users (HPDUs) suffer from low utilization of, and adherence to, primary care. Drug treatment programs that offer primary care on-site reduces this problem significantly by providing a social support structure. But in the United States, few HPDUs receive this demonstrably effective form of care. With support from NIDA (RO1 DA12112), we examine a functionally-equivalent, alternative support structure to on-site care for increasing active drug users' adherence to HIV therapeutics. HPDUs, randomly assigned to the experimental intervention, are invited to work with one another in accessing and keeping-up with their care by playing a Health Game, compared to respondents assigned to a usual-care intervention. The primary outcomes being examined include respondents' enrollment and retention in primary care, adherence to HIV therapeutics, entry and retention in drug treatment, reduction of drug and sex-related HIV risk behaviors, and enhancement of medical knowledge and self-management skills.METHODS: Active IDUs are recruited to the project for an HIV Counseling and Testing (C&T;) Session using Respondent Driven Sampling (RDS) - a coupon-based chain referral mechanism that uses active IDUs to recruit peers who know, think they know, or would like to know their HIV-status. Respondents who test positive for HIV are invited into the second phase of the project - a "health game" in which small teams of HPDUs work with each individual member to keep-up with his/her medical care by reaching objectively-documented health care goals per week. Teammates receive direct monetary rewards depending on how well each member plays the health game.RESULTS: During the 2001 operating year in New Haven, Connecticut, the project recruited and HIV test-counseled nearly five times the number of active IDUs (N=370) than did the New Haven Health Department (N=76). Seventy of the project's subjects test results were HIV+ (18.9%) versus 4 (5.3%) reported by the New Haven Health Department, a rate of 17 times. Thirty-eight HIV+ subjects enrolled in the second phase of the project. Access to health care was examined by comparing the experimental to the usual-care subjects' care data. The experimental subjects show an increase in HIV-related diagnoses, as well as enrollment in drug treatment during enrollment in the health game. At entry into the project both experimental and usual-care subjects show an increase in drug/alcohol-related diagnoses. For experimental subjects, however, such diagnoses decrease upon completion of their year-long involvement in the project.CONCLUSIONS: The RDS demonstrated to be a powerful method for accessing and recruiting active IDUs into HIV C&T; who might otherwise not be tested. While enrollment of HIV+ subjects into the Health Game has been sporadic, the data demonstrate an increased utilization of health care by respondents who do. On a qualitative level, the experimental subjects have also expressed many interesting positive experiences in being given the opportunity to help others get into and keep-up with their care. Additional results will be reported as our analysis of the data continues.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Connecticut
- Counseling
- HIV Infections
- HIV Seropositivity
- Peer Group
- Primary Health Care
- Social Support
- United States
- utilization
Other ID:
UI: 102261693
From Meeting Abstracts